Health Care

The Great Society's Next Frontier

(AP Photo/Susan Walsh)
(AP Photo/Susan Walsh) A copy of H.R. 3200, America Affordable Health Choices Act of 2009, sits on the desk of House Energy and Commerce Committee Chairman Henry Waxman, a Democrat from California. A s The Washington Post ’s Ezra Klein declared shortly after voters re-elected President Barack Obama, one of the major winners last week was health-care reform. With Democrats holding on to the Senate and the White House, Republicans will be unable to repeal the law before all of its provisions go into effect in 2014—after which, the theory goes, the public will come to accept that government has the responsibility to ensure health care is available for all. This is the end of a long battle for progressives: Health care has been the major missing piece of our welfare state for nearly a century, and for decades making it part of our system of social insurance has been a primary goal of politicians, think tanks, and activists. With this piece of the progressive puzzle in place, the natural...

The Moral Question of the Medicaid Expansion

Uninsured people getting medical care at an event in Los Angeles earlier this year. (Flickr/Neon Tommy)
In the last four years, we've seen a lot of reflexive, frankly dickish anti-Obamaism from Republicans at all levels. Much of it is relatively harmless; when some knuckle-dragging congressman goes on talk radio to air his suspicions that Obama's birth certificate is a forgery, there may be some chipping away at the President's legitimacy, but no one's life is affected directly. But there are some cases where Republicans are willing to do direct, substantial, even life-threatening harm to thousands or even millions of people, for no other reason than to demonstrate their unflagging hatred for the man in the Oval Office. I'm talking here about the coming expansion of Medicaid, which didn't get discussed much during the campaign, but which is the most profound effect of the passage of the Affordable Care Act. As you'll recall, when the Supreme Court upheld the individual mandate, it gave a gift to Republicans too, saying states could opt out of the law's expansion of Medicaid, under which...

Defending the Right to Treat Your Employees Like Dirt

Papa Johns? More like Papa Jerk's! Thank you, I'll be here all week. (Flickr/jumbledpile)
Getting tired of eating at Chick-Fil-A every day to express your hatred of liberals? Well, now you have a couple more options. You can chow down at Applebee's, where the CEO of their New York franchises went on TV to declare that he won't be doing more hiring because of the costs Obamacare would impose. Or you can head over to Papa John's, whose CEO, John Schnatter, has said that Obamacare could add as much as—brace yourself—10 cents to the cost of a pizza, and since obviously customers would never tolerate such price gouging, he'll just have to cut back employees' hours. In our new era of corporate political activism, we're goin to be seeing a lot more of this kind of thing. So let's make sure we all understand exactly what it is these chieftains are complaining about: They don't want to give their employees health insurance . That's it. They'd prefer to talk about "regulation" in some general sense, so you might get the impression that Obamacare is making them needlessly remodel...

Nancy Pelosi, Same Job, Different Coalition

(Flickr/Talk Radio News Service)
(AP Photo/Pablo Martinez Monsivais) House Minority Leader Nancy Pelosi holds a news conference with newly elected Democratic House members on Capitol Hill. N ancy Pelosi has confounded expectation before. Following the 2010 midterm elections, when Republicans recaptured the House on a wave of Tea Party indignation, Pelosi was widely, and unjustly, criticized for leading House Democrats to debacle. She had played a key role in enacting Obamacare, a program that the Obama administration chose not to defend as Election Day drew nigh. She had not paid enough attention to solving the recession, critics argued, though in fact House Democrats had passed additional stimulus measures that failed to surmount Senate filibusters. It was time, the critics said, for her to go. But Pelosi disagreed, and her House colleagues turned out to be in no mood to challenge her decision. Now, once again, she has surprised the Washington conventional wisdom by signing on for another two years atop the House...

When It Comes to Lady Politicians, We've Got a Long Way to Go

(Flickr/Leader Nancy Pelosi)
(AP Photo/Michael Dwyer) Democrat Elizabeth Warren takes the stage after defeating incumbent GOP Senator Scott Brown in the Massachusetts Senate race, during an election night rally at the Fairmont Copley Plaza hotel in Boston, Tuesday, November 6, 2012. I t's made for a great narrative: Tuesday night, female candidates prevailed in nearly all the tightest, most-watched Senate races around the country. A historic number of women will now serve in the upper chamber, once the boysiest of boys' clubs. If that wasn't enough to prompt some girl-power cheering, there was the news out of New Hampshire that, with the election of Maggie Hassan to the state's top executive spot, the governor, senators, and congressional representatives now all carry XX chromosomes. Several commentators have noted there's still a long way to go. But perhaps, more notably, there's little evidence that these wins are part of a wider trend for female candidates. The political gains were most notable in the Senate,...

Will Massachusetts Voters Legalize Assisted Suicide?

This is the ninth in the Prospect's series on the 174 measures on state ballots this year. Six years ago, Mesfin Nega was attacked outside a nightclub. He suffered a broken neck and a damaged spinal cord that transformed the previously healthy 32-year-old into a quadriplegic. As The Washington Post later reported , Nega had made a pact with his friend Shimelis Yegazu: If one were ever to suffer an injury that required him to be connected to life-sustaining equipment, the other would take it upon himself to disconnect the equipment. Nega and Yegazu made the news last week when Yegazu followed through with this pact, administering a lethal dose of phenobarbital to Nega, and then taking a fatal dose himself. Nega’s story raises a question that has been off the political radar for some time: Should a patient who wants to end his or her own life have the right to receive a physician’s assistance doing so? Debate here doesn't fall along usual partisan lines—there is no party orthodoxy for...

Anti-Obamacare Ballot Measures: Purely Symbolic, Sometimes Ironic

(Flickr/Fibonacci Blue)
This is the seventh in the Prospect's series on the 174 measures on state ballots this year. Ever since the Affordable Care Act (ACA) passed, Republicans have been desperate for ways to gut it. They hoped the Supreme Court might do the dirty work, but the Court ruled this summer that the law was constitutional. They hoped to pass new legislation, but as long as Democrats have the White House and the Senate, that's a non-starter. So instead, for the time being, they are turning to purely symbolic acts of defiance. Four states have ballot measures on November 6 that, if passed, would directly conflict with the ACA. In Alabama, Florida, Montana, and Wyoming, voters can ostensibly decide to ban any and all mandates that residents get health insurance. But these "bans" would exist in name only. That's because the measures would violate Obamacare, which requires that the state's residents get health insurance or pay a fine (which the Supreme Court calls a tax). These measures will have no...

A Bumper Crop of Pot Referenda

(Flickr/Torben Bjørn Hansen)
In the halls of state legislatures, few folks laugh at the exploits of Cheech and Chong or Harold and Kumar. There is a bipartisan consensus that marijuana laws are political kryptonite, as if touching the topic of drug legalization, even medicinally, might prompt immediate backlash. The lack of mainstream support is surprising, given that sizeable groups in both parties have long clamored for an end to the “War on Drugs.” Some drug war critics point to the costs, both societal and budgetary, associated with imprisoning millions of people for a crime that doesn’t seem to hurt anyone. Others like the fiscal possibilities for marijuana legalization: If pot is legal, it will be taxable, and at a time when state governments are starved for cash, any possibility for new revenue is an opportunity. Though mainstream lawmakers remain reluctant, citizens seem to be warming to the idea of marijuana as something other than an illegal substance. (Maybe stoner movies have had some success.) A 2011...

Arlen Specter: A Poor Man's Richard Nixon

From Democrat to Republican to Democrat again, from his fierce opposition of Robert Bork to his cutthroat cross examination of Anita Hill, Specter was always, above all, a politician.

(Flickr/ProgressOhio)
Flickr/musicFIRSTcoalition W hen Arlen Specter, the former Pennsylvania Senator who died Sunday at the age of 82, was negotiating to become a Democrat in 2009, he believed that he would retain his GOP-acquired seniority on the Senate committees in which he served. Specter thought he’d gotten a commitment from Majority Leader Harry Reid—Specter’s switch would not only help him avoid a primary challenge from the right, but would give the Democrats 60 votes in the Senate. However, the Democratic caucus resented the idea that Specter could jump ahead of lifelong Dems on the seniority list. Reid was thus unable to keep the agreement with Specter. Losing the committee seniority, Specter said, according to Politico , “was the worst moment of my life.” The worst moment of a then-79-year-old man’s life? Think about that. Specter had, by then, lost his parents. He had gone through several bouts of cancer, a benign brain tumor, and cardiac bypass surgery in the previous decade. He had two...

Medicaid Is the Real Target

Since August, when Mitt Romney chose Paul Ryan as his running mate, the two campaigns have fought a fierce battle over who is the most stalwart protector of Medicare. In the first presidential debate, Romney assailed President Obama for his $716 billion in Medicare cuts, and Ryan did the same in last week’s vice presidential face-off. Likewise, the Obama campaign has hit Team Romney for the Ryan plan and its Medicare “premium support”—which, if implemented, would gradually replace traditional Medicare with subsidized, regulated private insurance. The irony is that—in the short term, at least—Medicare will stay unchanged, regardless of who wins the election. Seniors are among the most mobilized voters in the electorate, and there’s too much political risk involved in making big, immediate changes to Medicare. For that reason, Medicare reform plans on both sides are backloaded and will take time to unfold. The same isn’t true of Medicaid, the other major federal health-care program. The...

Are Women Better Off Than We Were Four Years Ago: Take Two

The story so far. Last week I objected to the question “Are you better off now than you were four years ago?” I object to the idea that my well-being can be reduced purely to economics, or to few things that the president can affect. (One colleague wrote: My 90-year-old mother would certainly say she’s not better off than she was four years ago, but that’s more about her health than about her wallet!) So I’m going to hijack that question for my own purposes and ask: Are women better off than we were four years ago—not just financially, and not just in ways affected by President Barack Obama’s administration, but overall? Last week we checked in on our financial well-being, given that finances are indeed important. But there’s more to life than our checkbooks and retirement plans. So welcome to Episode Two: Our Bodies, Our Well-Being. There’s some good news and some bad news. As you know, this past year, some prominent menfolk have been deeply distressed to learn that we believe that...

Obama: Giving Away Social Security

(AP/Rex Features)
Here is Mitt Romney’s proposal to cut Social Security benefits, from the Romney campaign website : First, for future generations of seniors, Mitt believes that the retirement age should be slowly increased to account for increases in longevity. Second, for future generations of seniors, Mitt believes that benefits should continue to grow but that the growth rate should be lower for those with higher incomes. In other words, cuts in benefits. In the first debate, I was waiting for President Obama to go to town on this. Instead, Obama had this to say: LEHRER: "Mr. President. Do you see a major difference between the two of you on Social Security?" OBAMA: "You know, I suspect that, on Social Security, we’ve got a somewhat similar position. Social Security is structurally sound. It’s going to have to be tweaked the way it was by Ronald Reagan and Speaker — Democratic Speaker Tip O’Neill." He’s got a similar position to Mitt Romney’s? On Social Security? Does this man just want to hand the...

Better Know a Ballot Measure

(Flickr/radarxlove and jamelah e.)
When Oregon voted on the nation’s first ballot initiative in 1904, the idea—as high-school civics teachers have told students ever since—was to take power away from the industries that ran the state legislature through bribes and corruption and return it to the people. In those days, corporate interests dominated and corrupted state politics all across the United States. Mining and railroad companies loomed particularly large, buying off entire legislative chambers and putting lawmakers on their payroll. The emerging progressive movement thought it had found a way to fight back: Give citizens the ability to create their own legislation and put it up for a popular vote—a process known as the initiative. There was also the referendum, a tool citizens could use to veto laws at the ballot box. These ballot measures offered a way for the grassroots to make their voices heard. As your civics teacher might have told you, several states would soon join Oregon in using the new power of “direct...

Reaping What Elections Sow

(Flickr/ BKM_BR)
In 2010, Tea Party mania influenced elections at every level—congressional races and governorships, most famously. But the biggest impact was on state legislatures, where 21 house or senate chambers flipped from Democratic to Republican control. In states like Texas, Republican majorities turned into supermajorities; in the Texas House, Democrats were no longer needed to make up a quorum. All the legislative energy was on the side of Tea Party Republicans. They made sweeping, historic changes—to labor laws, to health care, to reproductive rights, and, most of all, to state budgets and public school funding. In a few weeks, voters in most states will be choosing new lawmakers again. They'll make their decisions based in part on how they believe the incumbents governed over the last two years. But because of the massive scale of changes ushered in by Tea Party Republicans, it's going to be extremely difficult—if not downright impossible—for voters to judge the effects of those changes...

When the Fringe Shapes the Center

During the AIDS crisis, ACT UP's radicalism forced more mainstream gay-rights groups to step up their game.

(AP Photo/Tim Clary, File)
(AP Photo/Tim Clary, File) Act Up protestors lie on the street in front of the New York Stock Exchange in a demonstration against the high cost of the AIDS treatment drug AZT in September of 1989. S tarting with my inability to believe Mitch McConnell isn't one of Disney's talking teapots gone rogue, there are plenty of good reasons I don't and shouldn't run the zoo. But if I did, How To Survive A Plague would be mandatory viewing for Occupy Wall Streeters. First-time director David France's new documentary about the 1987-'93 glory years of ACT UP—aka AIDS Coalition To Unleash Power, in case you've forgotten—is a wrenching remembrance of a gay holocaust that's already dimmer than it should be in our memory. The movie is also an exhilarating portrait of human beings discovering what they're capable of in a crisis. But above all, it's the story of how a never too numerous band of obstreperous activists successfully changed public policy. On that count, France may gild the lily somewhat...

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